Affluent health trusts' deposits to the Midlands NHS bank are being used to bail out their struggling counterparts else-where in the region, it was revealed yesterday.
Figures published by NHS West Midlands, the new strategic health authority (SHA), also showed eight primary care trusts (PCTs) already reporting deficits - just three months into this financial year.
In January the Department of Health drew up plans for a central NHS Bank from which ailing acute trusts could withdraw loans to help pay deficits incurred during 2005/06.
Each PCT in England has paid in, on average, three per cent of their development reserve for 2006/07 to help financially challenged trusts tackle their debts.
Midland trusts have deposited £187 million into this bank, with a dozen health organisations across the region being given loans ranging from £4 million to £37 million, which must be paid back over the next four years at a rate of 4.5 per cent.
But figures presented at NHS West Midlands board meeting yesterday revealed an uneven spread of these grants, with trusts in Birmingham and the Black Country effectively funding massive grants to trusts in Staffordshire and Warwickshire.
Heart of Birmingham, Sandwell and South Birmingham PCTs collectively paid in £38.1 million to the pot, with Sandwell and West Birmingham Hospitals NHS Trust - which runs debt-ridden City and Sandwell hospitals - receiving an £11 million loan.
Similarly Dudley, Walsall and Wolverhampton PCTs have deposited £31 million in total, with Royal Wolver-hampton Hospitals receiving £16.3 million and West Midlands Ambulance Service granted £4.3 million.
But in Warwickshire, the county's five PCTs have put £19.6 million in the bank, but loans paid out to two bodies, Coventry PCT and South Warwickshire General Hospitals NHS Trust, total £48.8 million.
Similarly in Staffordshire P CTs have contributed £36.4 million but loans totalling £48.6 million have been granted, of which £37 million has been gone to crisis-hit University Hospital of North Staffordshire.
David Poynton, NHS West Midlands' interim finance director, said: "This is some-thing which affects the whole NHS, not just West Midlands trusts, and it's not optional it's mandatory.
"This is not about writing off deficits, it's about buying time for trusts to address what are fundamental financial issues.
"We're one new West Midlands body now, and as such this money has got to benefit trusts across the whole region, therefore we will have to move that money about.
"What's the alternative? To decimate services in order to achieve financial balance?"
Although the NHS bank was seen as a "one-off" to help financially challenged trusts get back into the black, its local advisory council could opt for a second round of "top slicing" if health trusts' problems persist.
Mr Poynton, an accountant, added: "We're waiting to see how trusts predicting deficits this year manage over the next few months, obviously we're worried about this, but we will be meeting those organisations over the next six weeks."
Last night Peter Sawyer, finance director for Royal Wolverhampton Hospitals NHS Trust, said: "All the PCTs have paid a small percentage of their budgets into this bank.
"If money to tackle these deficits does not come from a central bank, it would then have to come from overspending, which would just be counterproductive."
A Heart of Birmingham PCT spokesman added: "This step has been agreed by all PCTs and hospital trusts, so the geography of where the money goes isn't an issue.
"People will probably remain loyal to their local hospitals but in the future, when Patient Choice is fully established, they may be prepared to travel further to see a particular consultant or be seen more quickly."
A report, commissioned by Health Secretary Patricia Hewitt, to find a strategy for dealing with the huge deficits incurred by some trusts was also published yesterday.
Cumulative deficits, which currently stand at £1.1 billion, would effectively "lay on file" and attention would be focused on trusts going forward.